152 articles - From Friday Aug 05 2022 to Friday Aug 12 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
ACG Clinical Guideline: Gastroparesis. When the evidence was not appropriate for Grading of Recommendations, Assessment, Development, and Evaluation, we used expert consensus to develop key concept statements. These guidelines should be considered as preferred but are not the only approaches to these conditions. |
| Gut |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
Randomised clinical trial and meta-analysis: mesalazine treatment in irritable bowel syndrome-Effects on gastrointestinal symptoms and rectal biomarkers of immune activity. Mesalazine is ineffective in reducing IBS symptoms. Rectal measures of immune activity by the mucosal patch technology cannot predict a higher chance of response to mesalazine. |
Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome. Peppermint oil was superior to placebo for the treatment of IBS, but adverse events were more frequent, and quality of evidence was very low. Adequately powered RCTs of peppermint oil as the first-line treatment for IBS are needed. |
| Clin Gastroenterol Hepatol |
Comparative Risk of Serious Infections with Biologic Agents and Oral Small Molecules in Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis. Vedolizumab may offer net benefit over TNFa antagonists in patients with UC, but not in CD. Ustekinumab may offer net benefit over TNFa antagonists and vedolizumab in patients with CD. |
Disease state transition probabilities across the spectrum of NAFLD: A systematic review and meta-analysis of paired biopsy or imaging studies. In our meta-analysis, progression to NASH was more common than regression from NASH. Rates of fibrosis progression were similar across baseline stage, but patients with advanced fibrosis are more likely to regress than those with mild fibrosis. |
Hepatocellular Carcinoma Incidence in Alcohol-associated Cirrhosis: Systematic Review and Meta-analysis. Our analysis determined that the 5- and 10- year cumulative risk of HCC in alcohol-associated cirrhosis was 3% and 9% respectively, with a higher incidence in cohorts that were enrolled in a HCC surveillance program. These data should be further validated in large, prospective studies, and may have important implications for HCC screening and surveillance among patients with alcohol-associated cirrhosis. |
| Gastrointest Endosc |
Diagnostic accuracy of endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) by macroscopic on-site evaluation (MOSE): A systematic review and meta-analysis. Excellent pooled diagnostic accuracy parameters were demonstrated in EUS-guided tissue acquisition by FNB using the MOSE method. |
Efficacy of topical hemostatic agents in malignancy-related gastrointestinal bleeding: a systematic review and meta-analysis. THAs are highly effective for achieving primary hemostasis in malignancy-related GI bleeding. It should be considered as an alternative to traditional endotherapy methods in malignancy-related GI bleeds. Future studies should be designed to evaluate its efficacy and safety as a primary method of hemostasis as compared to traditional endotherapy measures. |
| J Crohns Colitis |
Placebo rates in randomized controlled trials of proctitis therapy: A systematic review and meta-analysis. Placebo response and remission rates in proctitis trials are influenced by trial phase and the endpoint being assessed. These contemporary rates will inform trial design for novel therapeutics for treatment of proctitis, which is a large unmet need. |
RCT, clinical trials, retrospective studies, etc…
| Am J Gastroenterol |
Pancreatic Elastography Predicts Endoscopic Secretin-Pancreatic Function Test Result in Patients With Early Changes of Chronic Pancreatitis: A Prospective, Cross-Sectional, Observational Study. The degree of pancreatic fibrosis as evaluated by EUS-E correlates significantly with the secretin-stimulated pancreatic secretion of bicarbonate in patients with clinical suspicion of CP and inconclusive EUS findings of the disease. EUS-E could replace ePFT for the evaluation of these patients in clinical practice. |
Social Media for the Dissemination of Educational Videos About Inflammatory Bowel Diseases. We showed the feasibility of large-scale dissemination of health-related educational videos through social media. Our findings can inform future online dissemination approaches of educational content. |
The Cardiorenal Connection: Is Cardiac Output the Sole Determinant of Renal Dysfunction in Cirrhosis? It is possible that the authors were only assessing 1 aspect of cardiac dysfunction in a group of patients who were not at the very end stage of cirrhosis. Their unexpected findings will certainly stimulate further research into the role of cardiac dysfunction in the pathogenesis of acute kidney injury in cirrhosis. |
| Clin Gastroenterol Hepatol |
Cost-effectiveness of earlier or more intensive colorectal cancer screening in overweight and obese patients. CRC screening starting at age 45 with colonoscopy, or 40 with FIT, appears cost-effective for women and men across the range of BMI. In men with obesity II-III, who have the highest CRC but also all-cause mortality risks, colonoscopy starting at 40 appears cost-effective. It remains to be decided whether BMI should be used as a single predictor or incorporated into a multivariable tool to tailor CRC screening. |
Geographic Density of Gastroenterologists is Associated with Decreased Mortality from Alcohol-Associated Liver Disease. State-level geographic density of gastroenterologists is associated with lower ALD-related mortality. These results may inform medical societies and health policymakers to address anticipated workforce gaps to address the growing epidemic of ALD. |
High Perceived Stress is Associated with Increased Risk of Ulcerative Colitis Clinical Flares. Increased fecal calprotectin was associated with cardioautonomic measures suggesting lower parasympathetic activity. Increased PS assessed at baseline is associated with tonic sympathetic arousal and greater odds of clinical flares in UC subjects. |
Long-term survival after endoscopic resection for gastric cancer: Real-world evidence from a multicenter prospective cohort. ER can be recommended as a standard treatment for EGCs patients fulfilling Category A2, A3 and B as well as A1 (UMIN Clinical Trial Registry, UMIN000005871). |
Neighborhood-level factors contribute to disparities in hepatocellular carcinoma incidence in Texas. /Impact We found evidence that neighborhood-level factors are differentially associated with variations in HCC incidence across Texas. Our findings reinforce existing knowledge about HCC risk factors and expose others, including neighborhood-level employment status. |
Prognostic Value of Fecal Calprotectin to Inform Treat-to-Target Monitoring in Ulcerative Colitis. Although FCP had only modest cross-sectional accuracy in identifying disease activity, an FCP concentration of =250 µg/g vs >250 µg/g was associated with increased probability of achieving long-term clinical, endoscopic, and histologic remission, and reduced probability of colectomy and UC-related hospitalization (ClinicalTrials.gov NCT00783718, NCT00790933, NCT02497469). |
Racial, Ethnic, and Socioeconomic Disparities in Treatment Delay among Patients with Hepatocellular Carcinoma in the United States. Nearly one in seven patients with HCC experience treatment delays, with higher odds in Black patients and those living in high poverty neighborhoods. Treatment delays are associated with worse survival, highlighting a need for interventions to improve time-to-treatment. |
Safety and sustained efficacy of the farnesoid X receptor (FXR) agonist cilofexor over a 96-week open-label extension in patients with PSC. In this 96-week OLE of a phase 2 study of PSC, cilofexor was safe and improved liver biochemistry and biomarkers of cholestasis and cellular injury. identifier NCT02943460. |
| Endoscopy |
Artificial intelligence-based diagnosis of abnormalities in small-bowel capsule endoscopy. For junior doctors, the assistance of the AI model increased the overall accuracy from 85.5% to 97.9% ( 0.0125, Bonferroni corrected). CONCLUSIONS : This well-trained AI diagnostic model automatically diagnosed multiple small-bowel abnormalities simultaneously based on video-level recognition, with potential as an excellent auxiliary system for less-experienced endoscopists. |
| Gastroenterology |
Clinical manifestations and stool load of atypical enteropathogenic E. coli infections in U.S. children and adults. AEPEC is associated with a wide array of symptoms in adults ranging from asymptomatic carriage to severe diarrhea. Higher EPEC loads are associated with presence of symptoms, but bacterial load does not predict disease or severity. Future studies are needed to understand bacterial and host factors that contribute to aEPEC pathogenicity to improve diagnostic tools and clinical care. |
Combined MEK and STAT3 inhibition uncovers stromal plasticity by enriching for cancer-associated fibroblasts with mesenchymal stem cell-like features to overcome immunotherapy resistance in pancreatic cancer. Combined MEKi+STAT3i mitigates stromal inflammation and enriches for CAF phenotypes with mesenchymal stem cell-like properties to overcome immunotherapy resistance in PDAC. |
Gut Microbiota Alter Visceral Pain Sensation and Inflammation via Modulation of Synthesis of Resolvin D1 in Colonic Tuft Cells. Our findings indicate that RvD1 is generated in colonic tuft cells to regulate gut sensitivity to mechanical stimulation. Colonic commensal bacterial composition regulates the synthesis of RvD1 in colonic mucosa which is reduced in IBS-D patients. This appears to be mediated by elevated fecal lipopolysaccharide secondary to gram-negative gut dysbiosis. |
Histone deacetylase inhibition by gut microbe-generated short chain fatty acids entrains intestinal epithelial circadian rhythms. Gut microbe-generated SCFAs entrain intestinal epithelial circadian rhythms by an HDACi-dependent mechanism, with critical implications for understanding microbial and circadian network regulation of intestinal epithelial homeostasis. |
Latiglutenase Protects the Mucosa and Attenuates Symptom Severity in Patients with Celiac Disease Exposed to a Gluten Challenge. The 3 x 2-week trend-line significance for these symptoms, respectively, were p = .014, .030 and .002 CONCLUSION: IMGX003 reduced gluten-induced intestinal mucosal damage and symptom severity. number NCT03585478. |
The rising burden of inflammatory bowel disease in Denmark over two decades: a nationwide cohort study. The IBD population is shifting towards an older age. These findings have implications towards understanding environmental shifts as well as preparing healthcare systems for an aging IBD population. |
| Gastrointest Endosc |
GIE Editorial Board Top 10: Advances in GI endoscopy in 2021. The 10 areas identified collectively represent advances in the following endoscopic topics: colonoscopy optimization; bariatric endoscopy; endoscopic needle sampling and drainage; per oral endoscopic myotomy (POEM); endoscopic defect closure; meeting systemic challenges in endoscopic training and practice; endohepatology; fine needle aspiration vs biopsy; endoscopic mucosal and submucosal procedures, cold snare polypectomy. Each board member contributed a summary of important articles relevant to 1-2 of the consensus topic areas, leading to a collective summary that is presented in this document of the "top 10" endoscopic advances of 2021. |
Liver Flukes Diagnosed by Endoscopic Retrograde Cholangiopancreatography in a Local Immigrant Community. The diagnosis of Clonorchiasis should remain on the differential diagnosis for patients with nonspecific biliary symptoms who have known risk factors for this uncommonly common pathogen. |
Timing of Colonoscopy in Acute Lower Gastrointestinal Bleeding: A Multicenter Retrospective Cohort Study. Early colonoscopy increased the rate of SRH identification and shortened LOS, but involved an increased risk of rebleeding and did not improve mortality and IVR/surgery requirement. Early colonoscopy benefited particularly patients with shock index =1 or performance status =3 at presentation. |
Visualizing Endoscopy- Generated Aerosols with Laser Light Scattering. We illustrate in an objective manner that upper GI endoscopy is an AGP. These findings may have implications for transmission of infectious airborne pathogens outside of SARS-CoV-2 and can help to inform guidance on appropriate personal protective equipment use and other measures for transmission risk mitigation during GI endoscopy. |
| Gut |
Integrated metagenomic and metabolomic analysis reveals distinct gut-microbiome-derived phenotypes in early-onset colorectal cancer. Our large-sample multiomics data suggest that altered microbiome-metabolome interplay helps explain the pathogenesis of EO-CRC and LO-CRC. The potential of microbiome-derived biomarkers as promising non-invasive tools could be used for the accurate detection and distinction of individuals with EO-CRC. |
Molecular heterogeneity and commonalities in pancreatic cancer precursors with gastric and intestinal phenotype. PDAC precursors with gastric and intestinal phenotype are heterogeneous in terms of morphology, genetic and epigenetic profile. This heterogeneity is related to a different cell identity and, possibly, to a different aetiology. |
| Hepatology |
Differential requirement of Hippo cascade during CTNNB1 or AXIN1 mutation driven hepatocarcinogenesis. Our studies demonstrate that YAP/TAZ are major signaling molecules downstream of LOF AXIN1 mutant HCCs, and targeting YAP/TAZ as an effective treatment against AXIN1 mutant human HCCs. |
Hepatocyte Ltb4r1 promotes NAFLD development in obesity. LTB4/Ltb4r1 promotes hepatocyte lipogenesis directly by activating PKA-IRE1a-XBP1s to promote lipogenic genes expression. Inhibition of hepatocyte Ltb4r1 improved hepatic steatosis and insulin resistance. Ltb4r1 is a potential therapeutic target for NAFLD. |
Intrahepatic paracrine signaling by CLCF1 ameliorates diet-induced NASH in mice. Hepatocyte-specific inactivation of LIFR accelerated NASH progression in mice, supporting an important role of intrahepatic cytokine signaling in maintaining tissue homeostasis under metabolic stress conditions. Together, this study sheds light on the molecular nature of intrahepatic paracrine signaling during NASH pathogenesis and uncovers potential targets for therapeutic intervention. |
Mortality after transjugular intrahepatic portosystemic shunt in older adult cirrhotic patients: a validated prediction model. After TIPS implantation, mortality is increased by ageing, but TIPS placement should not be precluded in patients older than 70years. In older adults, creatinine and sodium levels are useful predictors for decision making. Further efforts to update the prediction model with larger sample size are warranted. |
Multi-omics characterization of mouse hepatoblastoma identifies novel YAP1 target genes. Our chromatin profiling techniques define the regulatory frameworks underlying HB and identify novel, YAP1-regulated gene/enhancer pairs. JDP2 is an extensively validated target with YAP1-dependent expression in human HB cell lines and hepatic malignancies. |
Profiling of murine syngeneic HCC tumor models as a framework to understand anti-PD-1 sensitive tumor microenvironments. There is a wide diversity in the immune tumor microenvironments in preclinical models and in human HCC, highlighting the need to utilize multiple syngeneic HCC models to improve the understanding of how to treat HCC through immune modulation. |
TIGIT blockade elicits potent anti-tumor immunity in naturally occurring hepatitis B virus-related hepatocellular carcinoma in mice. Blockade of TIGIT alone enhanced the anti-tumor activity of CD8 + T cells during the progression of HBV-related HCC in a spontaneous HCC mouse model. |
| Inflamm Bowel Dis |
Cost-effectiveness Analysis of Subcutaneous Infliximab for Inflammatory Bowel Diseases in Sequential Biologic Treatment. Based on the ICERs, treatment sequences starting with infliximab are the dominant option for patients with UC in the United Kingdom, and patients with UC and CD in France. In UK patients with CD, ICERs were near the assumed "willingness to pay" threshold. These results reinforce the UK's National Institute for Health and Care Excellence recommendations for using infliximab prior to using vedolizumab in biologics-naïve patients. |
Crohn's Disease Patients Uniquely Contain Inflammatory Responses to Flagellin in a CD4 Effector Memory Subset. These findings demonstrate a Crohn's-associated flagellin-reactive CD4 cell subset distinct from UC patients and control subjects. There is a link between these cells and flagellin seropositivity. This CD4 cell subset could reflect a particular endophenotype of CD, leading to novel insight into its pathology and treatment. |
Occurrence and Clinical Impact of Eosinophilic Esophagitis in a Large Cohort of Children With Inflammatory Bowel Disease. The incidence and prevalence of EoE in children with IBD are low, although the incidence seems to be rising in recent years. Having EoE appears to be associated with a milder IBD disease course, whereas having IBD does not seem to affect the natural history of EoE. More data are needed to better define the phenotype of such association. |
Renal and Urological Disorders Associated With Inflammatory Bowel Disease. In this review, we evaluate the key literature relating to renal and urological involvement in IBD and emphasize the high index of suspicion required for the prompt diagnosis and treatment of these manifestations and complications, considering the potential severity and implications of acute or chronic loss of renal function. We also provide suggestions for future research priorities. |
Risks of Melanoma and Nonmelanoma Skin Cancers Pre- and Post-Inflammatory Bowel Disease Diagnosis. The risk of BCC preceding a diagnosis of UC is higher than in non-UC controls, compared with a generally increased risk of al NMSCs post-IBD diagnosis. Thiopurine and anti-TNF therapy increase the risks for skin cancers in persons with IBD after their diagnoses. |
Utilization of Colonoscopy Following Treatment Initiation in U.S. Commercially Insured Patients With Inflammatory Bowel Disease, 2013-2019. Fewer than half of newly treated IBD patients underwent colonoscopy within 3 to 15 months of initiating new treatment, suggesting low uptake of treat-to-target endoscopic disease monitoring in real-world practice. |
| J Crohns Colitis |
Available methods for benefit-risk assessment: lessons for inflammatory bowel disease drugs. The risks and benefits of each medical therapy must be discussed with the patient and a shared decision-making process is recommended. Future initiatives should be developed to perform a benefit-risk assessment considering the characteristics of inflammatory bowel disease drugs. |
Intestinal Epithelial Responses to IL-17 in Adult Stem Cells-Derived Human Intestinal Organoids. IL-17 induces the pyroptosis of ISCs and enterocytes, as well as mucin secretion of goble cells and IgA transcytosis of epithelial cells. Paradoxical gastrointestinal effects of IL-17 neutralizing antibodies may be associated with inhibition of mucin secretion and IgA transcytosis. The inhibition of pyroptosis using CASP1 inhibitors prevents IL-17-inducded cytotoxicity without compromising its beneficial effects. |
Venous thromboembolism following discharge from hospital in patients admitted for inflammatory bowel disease. IBD patients admitted to hospital with a prolonged length of stay, increasing age, male sex or as an emergency were at increased risk of VTE following discharge. Higher risk patients were identifiable by a VTE risk scoring system. |
| Neurogastroenterol Motil |
How big is the little brain in the gut? Neuronal numbers in the enteric nervous system of mice, Guinea pig, and human. This study reports the first comprehensive nerve cell count in mice, guinea pig, and human ENS. Neuronal densities were comparable between the three species and the differences in the total numbers of enteric neurons are likely due to body size and intestinal length. The number of enteric neurons is comparable to the number of neurons in the spinal cord for al three species. |
Proximal and distal intragastric meal distribution during gastric emptying scintigraphy: Relationships to symptoms of gastroparesis. Increased early distal IMD in patients with delayed GE was associated with regurgitation and early satiety whereas increased late proximal IMD was associated with nausea, retching, and vomiting. Differentiating proximal from distal meal distribution patterns helps to relate symptoms to gastric dysfunction and may be helpful for directing therapy. |
The impact of expectancy on the efficacy of acupuncture treatment for postprandial distress syndrome: Secondary analysis of a randomized clinical trial. In this study, the response rate and elimination rate were higher in the high-expectancy group, but no conclusive evidence was found for an association between expectancy and the efficacy of acupuncture and sham acupuncture. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
Hepatic Encephalopathy: Current and Emerging Treatment Modalities. After a brief overview of HE characteristics and pathophysiology, this review explores the current accepted treatments for this debilitating complication of cirrhosis. This is followed by an overview of the novel available therapies and a brief focus on future treatment modalities for HE. |
Management of Adults with Esophageal atresia. These include effects related to the underlying deformity such as atonicity of the esophageal segment, fistula recurrence and esophageal cancer to complications of the surgery including anastomotic stricture, gastroesophageal reflux and coping with an organ transposition. This review discusses the occurrence and management of these conditions in adulthood and the role of an effective transition from pediatric to adult care to optimize adult care treatment. |
Specific Challenges in Geriatric Cirrhosis and Hepatic Encephalopathy. To illustrate this point, we present 2 cases of older patients that were misdiagnosed as having dementia and Parkinson's disease or a parkinsonian syndrome but had contributions from cirrhosis. Both cognitive impairment and tremor resolved with treatment of HE. |
| Gastroenterology |
| Gut |
Recent advances in clinical practice: advances in cross-sectional imaging in inflammatory bowel disease. Coupled with their high sensitivity, these advantages have made MRE and IUS the primary non-invasive options for diagnosing and monitoring Crohn's disease; they are appropriate first-line investigations, and have become viable alternatives to colonoscopy. This review discusses cross-sectional imaging in IBD in current clinical practice as well as research lines that will define the future role of these techniques. |
| J Hepatol |
| Neurogastroenterol Motil |
Epigenetic modulation of visceral nociception. More recently, both animal models and human studies have shown how epigenetic regulation modulates stress-induced visceral pain. While much more work is needed to fully delineate the mechanistic role of epigenetics in the neurobiology of chronic visceral nociception, the current study by Louwies et al., in Neurogastroenterology and Motility provides additional evidence supporting the involvement of epigenetic alterations in the central nucleus of the amygdala in stress-induced visceral hypersensitivity in rodents. |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gut |
| Hepatology |
| Neurogastroenterol Motil |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |